Saito Seiichi, Murakami Gen
Art Park Urology Hospital and Clinic, and the Department of Anatomy, Sapporo Medical University, Sapporo, Japan.
Int J Urol. 2007 Oct;14(10):978-80. doi: 10.1111/j.1442-2042.2007.01819.x.
One of the major disadvantages of radical perineal prostatectomy used to be that lymphadenectomy could not be conducted through the same incision. We anatomically evaluate perineal pelvic lymphadenectomy using cadavers.
Three male specimens that had been subjected to pathological dissection were examined for perineal pelvic lymphadenectomy and the inside views were shown. Operation time, the number of lymph nodes and the inside views of cadavers were evaluated.
We can carry out obturator lymphadenectomy as well as partial internal iliac and external iliac lymphadenectomy between the obturator nerve and external iliac vein under direct vision or laparoscopy in about 20 min. The median number of lymph nodes removed from the three cadavers was eight. It may be easier after prostatectomy because there is then enough space.
This method resolves one of the major disadvantages of perineal prostatectomy and makes possible a wide variety of perineal operations.
根治性会阴前列腺切除术的主要缺点之一曾是无法通过同一切口进行淋巴结清扫。我们使用尸体对会阴盆腔淋巴结清扫术进行解剖学评估。
对3例已进行病理解剖的男性标本进行会阴盆腔淋巴结清扫术检查,并展示内部视图。评估手术时间、淋巴结数量和尸体内部视图。
我们可以在直视或腹腔镜下,于闭孔神经和髂外静脉之间,在约20分钟内完成闭孔淋巴结清扫以及部分髂内和髂外淋巴结清扫。从3具尸体上切除的淋巴结中位数为8个。前列腺切除术后进行该操作可能会更容易,因为那时有足够的空间。
该方法解决了会阴前列腺切除术的一个主要缺点,并使多种会阴手术成为可能。